BackgroundTo present our results using a novel "flapless" trocar-assisted intrascleral fixation technique for Carlevale intraocular lens (IOL) Implantation without conjunctival opening.MethodsRetrospective, non-comparati...BackgroundTo present our results using a novel "flapless" trocar-assisted intrascleral fixation technique for Carlevale intraocular lens (IOL) Implantation without conjunctival opening.MethodsRetrospective, non-comparative study of consecutive patients undergoing this technique. Patients older than 18 years who had at least two years post-operative follow-up were included.Results61 eyes of 61 consecutive patients were included in the analysis. The study sample included 55.74% males with a median age of 76 years (interquartile range (IQR): 67-82 years). The mean follow-up period was 48.9 months (SD ± 14.38) and the range was between 26 and 76 months. A statistically significant difference was observed between the median pre-operative visual acuity value (1.8LogMAR, IQR: 1.0-1.8) and the median postoperative value visual acuity (0.05 LogMAR, IQR: 0.0-0.1). No intraoperative complications occurred and, the Carlevale IOL was well centered in all cases. No haptic exposure was observed during the follow-up period.ConclusionThe results of our study demonstrate that the proposed technique is a simplified, safe and effective surgical approach for placement of the Carlevale IOL. Further studies are needed to validate our data and explore the results of a longer follow-up.
AimTo evaluate long-term postoperative visual outcomes and safety profile comparing immediate surgical treatment versus delayed management (more than one day) following posterior capsular rupture during cataract surgery....AimTo evaluate long-term postoperative visual outcomes and safety profile comparing immediate surgical treatment versus delayed management (more than one day) following posterior capsular rupture during cataract surgery.Material and MethodsThis retrospective cohort study included 154 eyes with posterior capsular rupture treated at Fondation Rothschild Hospital, Paris, from March 2022 to June 2023. Patients were divided into two groups: immediate management (same day, n = 117) and delayed management (>1 day, n = 37). Primary outcome was final corrected visual acuity. Secondary outcomes included postoperative complications, refractive outcomes, and intraocular lens (IOL) positioning.ResultsThe delayed group showed significantly higher rates of posterior vitrectomy (91.89% vs 21.37%, p < 0.001), iris/scleral fixated IOLs (21.62% vs 4.27%, p = 0.003), and multiple surgical interventions (2.35 ± 0.72 vs 1.20 ± 0.55, p < 0.001). Despite these differences, final visual acuity showed no statistically significant difference between groups (0.298 ± 0.364 vs 0.203 ± 0.308 LogMAR, p = 0.140). Multivariate analysis confirmed no association between timing of intervention and long-term visual acuity (OR: 1.58 [0.535-4.65], p = 0.409). Endothelial decompensation was significantly higher in the delayed group (8.11% vs 0.85%, p = 0.043), while other complications showed no significant differences.ConclusionDelayed IOL implantation following posterior capsular rupture can achieve satisfactory long-term visual outcomes comparable to immediate management, despite involving more complex cases requiring advanced surgical techniques. However, the increased risk of endothelial decompensation warrants careful monitoring. These findings suggest that delayed management is a viable option when immediate intervention is not feasible or optimal.
BackgroundCentral serous chorioretinopathy (CSCR) is an idiopathic disease characterized by changes in the macular region between the neurosensory retina the choroid and retinal pigment epithelium (RPE).ObjectiveCompare...BackgroundCentral serous chorioretinopathy (CSCR) is an idiopathic disease characterized by changes in the macular region between the neurosensory retina the choroid and retinal pigment epithelium (RPE).ObjectiveCompare pupillometry responses in CSCR patients with those of healthy individuals using automated pupillometry.MethodsA total of 52 subjects were included in the study (26 acute CSCR and 26 control). All subjects underwent a complete ophthalmologic examination, including optical coherence tomography (OCT) and enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). Both static and dynamic pupillometry measurements were performed under scotopic (0.1 cd/m), mesopic (1 cd/m), low-photopic (10 cd/m), and high-photopic (100 cd/m) light conditions. Dynamic pupillometry (resting PD, contraction amplitude, latency, duration, contraction velocity, dilation latency, and resting duration and velocity) measurements were performed using a white light stimulus in the dark.ResultsOn static pupillometry, low-photopic and scotopic pupil diameters were larger in the acute CSCR group ( = 0.003 and = 0.048, respectively), with no between-group differences under mesopic or high-photopic conditions. In the acute CSCR group, dynamic pupillometry parameters of contraction amplitude, dilation duration, and dilation latency significantly decreased ( = 0.024, = 0.011 and = 0.036, respectively), while initial pupil diameter and contraction latency increased ( = 0.026 and = 0.047, respectively).ConclusionsThe results of this study support the idea that autonomic nervous system dysfunction plays a contributing role in the pathophysiology of the disease and suggest that pupillometry can be used as a non-invasive screening tool for autonomic dysfunction.
PurposeTo compare the analgesic efficacy of 2% lidocaine gel and 0.4% oxybuprocaine eye drops in patients undergoing pterygium surgery, focusing on perioperative pain assessed in the early postoperative period and postop...PurposeTo compare the analgesic efficacy of 2% lidocaine gel and 0.4% oxybuprocaine eye drops in patients undergoing pterygium surgery, focusing on perioperative pain assessed in the early postoperative period and postoperative discomfort over one month.MethodsSixty-eight adult patients with bilateral primary nasal pterygia underwent two separate surgeries, one in each eye, at least 30 days apart. Each eye was randomly assigned to receive either 2% lidocaine gel or 0.4% oxybuprocaine eye drops for topical anesthesia. Pain perception was evaluated using the Visual Analog Scale (VAS) at 24 h and 30 days after surgery. VAS scores at 24 h reflected early perioperative pain as recalled in the immediate postoperative period, encompassing discomfort related to the surgical experience. Secondary outcomes included oral analgesic use during the first postoperative day and complications.ResultsThree patients declined second-eye surgery after marked discomfort during the first procedure performed with oxybuprocaine. The final sample comprised 133 eyes (68 eyes with oxybuprocaine, 65 with lidocaine gel). Mean VAS scores were significantly lower in the lidocaine group at 24 h (3.95 ± 3.14 vs. 5.09 ± 3.06; = 0.037) and 30 days (1.55 ± 2.14 vs. 2.69 ± 2.37; = 0.004). Analgesic intake within 24 h was less frequent with lidocaine gel (7.4% vs. 17.6%; = 0.145). No complications were observed.ConclusionsTopical 2% lidocaine gel provided superior analgesia compared with 0.4% oxybuprocaine, resulting in lower early perioperative pain assessed postoperatively and reduced postoperative discomfort after pterygium surgery, while maintaining an excellent safety profile.
PurposeTo describe the clinical features, intraoperative findings, and management outcomes of children with congenital nasolacrimal duct obstruction (CNLDO) complicated by atonic lacrimal sac.MethodsA retrospective revie...PurposeTo describe the clinical features, intraoperative findings, and management outcomes of children with congenital nasolacrimal duct obstruction (CNLDO) complicated by atonic lacrimal sac.MethodsA retrospective review was conducted on children diagnosed with CNLDO and intraoperatively confirmed atonic lacrimal sac between January 2017 and December 2023 at two tertiary centers. Data included demographics, clinical findings, type of obstruction, intervention, and outcomes. Success was defined as normal fluorescein dye disappearance with absence of epiphora or discharge.ResultsSixty-eight eyes of 65 children (median age, 3.5 years; range, 6 months-12 years; 60.3% males) were analyzed. Membranous obstruction was identified in 82.4% and firm obstruction in 16.2% of eyes. Probing alone was performed in 55 eyes (80.9%), while probing with additional intraoperative procedures were performed in 13 (19.1%), including silicone intubation in 11 and balloon dacryoplasty in 2. Success after the primary procedure was 67.6% at a mean follow-up of 9.9 ± 14.9 months. Younger age and membranous obstruction correlated with higher success. The additional procedures with probing did not have a significant impact on successful outcomes. Of 22 failures, 13 underwent secondary Dacryocystorhinostomy (DCR), all achieving complete anatomical and functional resolution.ConclusionsAtonic lacrimal sac represents an uncommon subtype of complex CNLDO. Most cases respond favorably to standalone probing combined with prolonged lacrimal sac compressions, particularly in younger children with membranous obstruction. DCR remains an effective second-line treatment for refractory cases.
PurposeTo evaluate the incidence of postoperative retinal displacement (RD) following three surgical techniques-pars plana vitrectomy (PPV), scleral buckling (SB), and pneumatic retinopexy (PR)-for macula-off rhegmatogen...PurposeTo evaluate the incidence of postoperative retinal displacement (RD) following three surgical techniques-pars plana vitrectomy (PPV), scleral buckling (SB), and pneumatic retinopexy (PR)-for macula-off rhegmatogenous retinal detachment (RRD).MethodsIn this retrospective observational study, 183 eyes with primary macula-off RRD were treated between June 2021 and June 2023 at a tertiary care retina center. Patients underwent one of three surgical techniques: PPV, SB, or PR. RD was assessed using fundus autofluorescence imaging and correlated with early face-down positioning (EFP) and other clinical variables.ResultsRD incidence varied by technique: 36.3% after PPV, 21.2% after SB, and 8.1% after PR. In PPV cases, gas tamponade was associated with higher RD rates than silicone oil (68.4% vs. 29.8%, = 0.010), and perfluorocarbon liquid (PFCL) use was associated with increased RD (44.1% vs. 0%, = 0.009). Adherence to EFP had no significant protective effect ( = 0.985). Metamorphopsia was more frequent in patients with RD ( = 0.040); final visual acuity was similar across groups.ConclusionsRD is most common after PPV and least frequent after PR. Surgical choices, particularly tamponade type and PFCL use, significantly influence RD risk and should guide surgical planning.
PurposeFollowing European Medicines Agency (EMA) approval, France implemented a managed access program (MAP) to provide brolucizumab to patients with neovascular age-related macular degeneration (nAMD) who lacked treatme...PurposeFollowing European Medicines Agency (EMA) approval, France implemented a managed access program (MAP) to provide brolucizumab to patients with neovascular age-related macular degeneration (nAMD) who lacked treatment alternatives. The French MAP data analysis evaluated efficacy and safety of brolucizumab in brolucizumab-naïve patients.MethodsOf 599 patients enrolled between February 2022 and January 2024, 360 pretreated with anti-VEGF therapy but brolucizumab-naïve were assessed at baseline for clinical and anatomical benefits of brolucizumab in a close-to-real-world setting.ResultsAfter 18 months, patients received a median of eight injections, maintaining visual acuity and achieving a mean central subfield macular thickness (CSMT) reduction of -92.0 µm among those with baseline CSMT ≥300 µm. Intraretinal fluid, subretinal fluid, and pigment epithelial detachment occurred in 32.8%, 75.3%, and 61.7% patients at baseline, and 16.5%, 47.0%, and 51.3% patients at 18 months. Patients previously requiring Q4 or Q5-Q7 injections successfully extended their intervals to Q8 or longer. Intraocular inflammation rate was 8.0% ( = 29).ConclusionResults demonstrated functional and anatomical benefits of brolucizumab in patients with refractory or suboptimally controlled nAMD, with a manageable safety profile. These findings highlight the potential of brolucizumab to reduce treatment burden in chronic nAMD.
Age-related Macular Degeneration (AMD) is a leading cause of vision loss. There is no cure for AMD. Current treatments focus on preventing disease progression and preserving vision. In recent years, the role of brain-der...Age-related Macular Degeneration (AMD) is a leading cause of vision loss. There is no cure for AMD. Current treatments focus on preventing disease progression and preserving vision. In recent years, the role of brain-derived neurotrophic factor (BDNF) in AMD has attracted increasing attention. BDNF is widely involved in the physiology and pathophysiology of the retina. These include the development of photoreceptors during early development and synaptic communication between photoreceptors and retinal neurons. Under pathological conditions, BDNF affects the functions of multiple cell types in the retina including photoreceptors, ganglion cells, Müller cells, microglia cells, amacrine cells, and the retinal pigment epithelium (RPE). Importantly, BDNF does not act alone. Its function relates with other neurotrophic factors such as basic fibroblast growth factor (bFGF), ciliary neurotrophic factor (CNTF), and glial cell derived neurotrophic factor (GDNF). Meanwhile, the dynamic interaction between BDNF, its precursor protein proBDNF and the BDNF receptor TrkB not only affects the survival of retinal cells in AMD but may also guide the treatment strategy. Various approaches have been taken to deliver BDNF in animal models for managing AMD. Despite the exciting progress, challenges remain in implementing BDNF therapy as an effective treatment. In this review, we summarize the current research progress of BDNF in AMD and highlight the issues that need to be addressed before translation into clinical practice.
PurposeTo evaluate the effect of sparing the horizontal meridian during Pan Retinal Photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) on corneal sensation, tear film parameters and to assess the pain in...PurposeTo evaluate the effect of sparing the horizontal meridian during Pan Retinal Photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) on corneal sensation, tear film parameters and to assess the pain in different retinal areas.DesignProspective comparative interventional studySubjectsPatients were randomized to either Group (A): conventional PRP or Group (B): PRP with sparing of the horizontal meridian.Main outcomeComparing the change in central corneal sensation and the precorneal tear film parameters between the 2 groupsMethods50 patients were divided into the two groups at random. The corneal sensation was evaluated by the Cochet Bonnet aesthesiometer & the tear film stability was evaluated by the Schirmer tests (1&2) & the Tear break up time (TBUT). The pain was recorded using a scale of 0-3 in different retinal areas.ResultsThe corneal sensation decreased with a nonsignificant difference between the 2 groups through the follow up visits. Regarding the tear film stability, Schirmer test (1), (2) & TBUT decreased with a significant difference in the change from the baseline between the 2 groups (-value for Schirmer test (1) <0.001, 0.001, 0.001, -value of Schirmer test (2) 0.007, 0.001, 0.001, -value of TBUT 0.03, 0.001, 0001 for 1 week, 1and 3 months respectively). Regarding the pain sensation during the PRP, the pain score was the highest in the horizontal meridian and was higher in the peripheral retina than in the central retina and in the lower retina than in the upper retina.ConclusionPRP performed with sparing of the horizontal meridian was found to maintain the tear film's stability with less pain increasing patient compliance with therapy.
PurposeTo evaluate the dynamics of retinal fluid in eyes compromised by exudative macular neovascularization beneath the retinal pigment epithelium (MNV type 1) secondary to neovascular age-related macular degeneration (...PurposeTo evaluate the dynamics of retinal fluid in eyes compromised by exudative macular neovascularization beneath the retinal pigment epithelium (MNV type 1) secondary to neovascular age-related macular degeneration (nAMD) and its impact on disease control over time.MethodsIn this retrospective single center study, 65 eyes of 65 patients with treatment-naive exudative MNV Type 1 were analyzed for the presence of subretinal fluid (SRF) and intraretinal fluid (IRF) in structural OCT B-scans for three years. All eyes started on three monthly intravitreal anti-VEGF injections followed by a personalized treatment interval. Primary outcome measure was visual acuity score (VAS) change based on fluid dynamics.Results29 (45%) eyes with SRF only started with a VAS of 74 ± 9 letters ETDRS, 20 eyes (31%) with SRF in the beginning that developed additional IRF had an initial VAS of 68 ± 11 letters, and 16 eyes (25%) with both, SRF and IRF measured 63 ± 13 letters at presentation. The VAS of all patients declined significantly ( = 0.003) over time, but no significant VAS change was measured between the groups.ConclusionIRF was regarded as a negative predictive OCT biomarker towards a lower VAS at the beginning but not necessarily during the course of the disease.
BackgroundTarsal ectropion is an advanced lower eyelid malposition characterised by full-thickness tarsal eversion, causing ocular discomfort and conjunctival inflammation. Its pathophysiology is multifactorial, involvin...BackgroundTarsal ectropion is an advanced lower eyelid malposition characterised by full-thickness tarsal eversion, causing ocular discomfort and conjunctival inflammation. Its pathophysiology is multifactorial, involving horizontal and vertical eyelid instability and chronic inflammation. Current evidence is limited to small, single-centre series with short follow-up and no comparative analysis of surgical approaches or perioperative corticosteroid use.MethodsWe conducted a retrospective, multi-centre cohort study at two UK ophthalmic centres, including 95 eyelids from 82 patients who underwent repair between 2012 and 2022. Surgical technique and perioperative corticosteroid use were recorded. The primary outcome was anatomical recurrence at final follow-up. Kaplan-Meier survival analysis and Cox proportional hazards regression were used. Median follow-up was 6 months (range 0-134).ResultsRecurrence rates were 34.8% at 12 months and 38.4% at 60 months. Combined horizontal and vertical stabilisation reduced recurrence compared with horizontal tightening alone (HR 3.2, 95% CI 1.49-7.04; = 0.003). Perioperative corticosteroid use lowered recurrence risk (HR 0.36, 95% CI 0.15-0.85; = 0.02). Regimens typically consisted of 0.1% dexamethasone (± neomycin/polymyxin B), 2-4 times daily for up to 2 months preoperatively or 2 weeks postoperatively. Most partial recurrences were minimally symptomatic, and long-term symptom scores showed no significant group differences.ConclusionsTarsal ectropion repair carries higher recurrence rates than previously reported. Outcomes are improved when both horizontal and vertical instabilities are corrected, with perioperative corticosteroids offering additional benefit by reducing inflammation. Prospective studies are needed to refine surgical strategies and clarify the role of adjunctive therapy.
PurposeThis meta-analysis aimed to evaluate the studies comparing transepithelial photorefractive keratectomy (TransPRK) to LASIK (Laser-Assisted In Situ Keratomileusis)/SMILE (Small Incision Lenticule Extraction) in ter...PurposeThis meta-analysis aimed to evaluate the studies comparing transepithelial photorefractive keratectomy (TransPRK) to LASIK (Laser-Assisted In Situ Keratomileusis)/SMILE (Small Incision Lenticule Extraction) in terms of visual outcomes for myopia, astigmatism and hyperopia.MethodsStudies from PubMed were included based on predefined criteria comparing TransPRK to LASIK/SMILE in terms of efficacy, efficacy index, safety, safety index, predictability, correction index, difference vector or index of success. A random-effects meta-analysis provided standardized mean differences, odds ratios (OR) and 95% confidence intervals (CI).Results17 studies with 5686 treated eyes met the inclusion criteria. Compared to LASIK, TransPRK showed a log(OR) of 0.09 (CI: -0.34 to 0.52) for efficacy, -0.85 (CI: -1.40 to -0.31) for safety (favoring LASIK) and 0.08 (CI: -0.28 to 0.44) for predictability. Compared to SMILE, TransPRK had a log(OR) of 0.77 (CI: -0.29 to 1.84) for efficacy, -0.3 (CI: -2.27 to 1.67) for safety and -0.91 (CI: -1.82 to 0) for predictability.ConclusionNo statistically significant differences were found between TransPRK and LASIK/SMILE in terms of efficacy and predictability. LASIK did show a significant safety advantage compared to TransPRK (negative log[OR], < 0.05) in the astigmatism and low-to-moderate myopia subgroup but the safety index did not. Procedure choice should be based on patient characteristics, laser availability, complication risk and surgeon experience, and not by performance in efficacy, safety or predictability While LASIK has a lower incidence of haze formation and SMILE offers a better biomechanical stability, TransPRK remains a suitable option especially in the hands of a less experienced surgeon.
PurposeTo evaluate epithelial thickness (ET) and corneal tomographic parameters in early-stage keratoconus (KC) patients with central cones, comparing eyes with and without a history of corneal collagen cross-linking (CX...PurposeTo evaluate epithelial thickness (ET) and corneal tomographic parameters in early-stage keratoconus (KC) patients with central cones, comparing eyes with and without a history of corneal collagen cross-linking (CXL).MethodsThis retrospective cross-sectional study included patients with early-stage keratoconus (Grade 1-2) and central cone localization diagnosed between 2020 and 2024. Central cones were defined by a maximum keratometry value within the central 3 mm zone, and one eye per patient was randomly selected. Eyes were classified as cross-linked (CXL+) or untreated (CXL-), with all treated eyes demonstrating clinical stability. Corneal tomography and epithelial thickness mapping were performed using Scheimpflug imaging and spectral-domain anterior segment optical coherence tomography.ResultsGroup 1 ( = 30 eyes) had a mean age of 24.6 ± 5.7 years, significantly younger than Group 2 ( = 33 eyes, 35.9 ± 9.0 years, < 0.05). The mean interval since CXL was 4.8 ± 3.2 years. Gender distribution did not differ significantly between groups. Among epithelial parameters, central ET was significantly thinner in CXL-treated eyes ( = 0.014), whereas peripheral ET values showed no significant differences. Tomographic comparison revealed a significant reduction in front apex thickness in Group 1 ( = 0.018), while other indices remained comparable.ConclusionIn early-stage central keratoconus, CXL-treated eyes demonstrated thinner central epithelial thickness compared to untreated eyes in a cross-sectional comparison. These findings suggest that epithelial remodeling may serve as a long-term biomarker of biomechanical stabilization after CXL, highlighting the clinical utility of epithelial mapping in the follow-up of keratoconus patients.
PurposeTo investigate the efficacy of lensectomy (LE) and the role of additional goniosynechialysis (LE-GSL) in eyes with medically uncontrolled synechial angle-closure glaucoma (ACG).MethodsThe records of patients who u...PurposeTo investigate the efficacy of lensectomy (LE) and the role of additional goniosynechialysis (LE-GSL) in eyes with medically uncontrolled synechial angle-closure glaucoma (ACG).MethodsThe records of patients who underwent LE or LE-GSL for >180° synechial ACG were reviewed retrospectively. Three groups were formed based on intraoperative gonioscopy (IOG) findings following lensectomy and intraocular lens implantation: Group 1 ( = 39), eyes with total peripheral anterior synechiae (PAS) in which GSL was performed; Group 2 ( = 37), eyes with PAS ≥ 180° and <360° in which GSL was performed; and Group 3 ( = 35), eyes with PAS < 180° in which no GSL was performed.ResultsA total of 111 eyes of 98 patients (M/F: 46/52; mean age: 60.1 ± 11.01 years) were included in the study. Median postoperative follow-up time was 12.0 months. Median PAS extents in the three groups were 12, 6, and 0 clock hours (CH) on IOG, compared to 12, 10, and 7 CH before surgery. GSL was performed in Groups 1 and 2, with a median of 11 and 4 CH. Median IOP at the final visit was 14 mmHg in all three groups. Total success rates were 87%, 81%, and 97% in Groups 1, 2, and 3, respectively ( = 0.102).ConclusionThe present study identified discrete groups of patients who would benefit from LE alone versus needing further GSL in synechial ACG. When PAS was <180° on IOG, LE alone effectively reduced IOP; in eyes with extensive PAS, performing additional GSL yielded successful results, comparable to eyes undergoing LE alone.
PurposeTo evaluate whether an algorithm that quantifies changes in hemoglobin (Hb) concentration in the optic nerve head (ONH) can detect progression in glaucomatous eyes with progressive visual field changes.MethodsThis...PurposeTo evaluate whether an algorithm that quantifies changes in hemoglobin (Hb) concentration in the optic nerve head (ONH) can detect progression in glaucomatous eyes with progressive visual field changes.MethodsThis retrospective cohort study involved eyes with primary open-angle glaucoma (POAG). Eyes were required to have at least five Standard Automated Perimetry (SAP) tests and three ONH photos during follow-up. ONH photos were processed using the Laguna ONhE software (Retinalyze, Spain). The software estimates Hb concentration at the ONH using automated colorimetric analysis. Visual field progression was defined based on the event-based algorithm provided by the guided progression analysis (GPA) software of the Humphrey perimeter. Changes in Hb levels from fundus photos during follow-up were calculated and receiver operating characteristic curve (ROC) regression models were used to assess the performance of Globin Individual Pointer (GIP) changes as an indicator of glaucomatous visual field progression.Results133 eyes of 102 subjects were included in the study, with 26 (20%) eyes demonstrating progression by the SAP GPA over an average follow-up time of 2.4 ± 1.6 years. The median (IQR) change in SAP mean deviation (MD) between the first and last visits was -2.20 (-4.65 to -0.62) dB in progressing and -0.01 (-1.17 to 1.03) dB in non-progressing eyes ( = 0.010). Progressing eyes had a median change of -4.9 (IQR: -10.4 to 3.1) GIP units, compared to -1.6 (IQR: -11.2 to 7.8) units for non-progressing eyes ( = 0.288). A statistically significant negative GIP slope ( < 0.05) was observed in two (7.7%) of the progressing eyes and 14 (13.1%) of the non-progressing eyes. Each 10-unit decrease in GIP during follow-up was associated with a 22% increase in the odds of progressing by GPA (OR: 1.22; 95% CI: 0.98-1.52; = 0.071), whereas a 10 unit/year faster slope was associated with 6% higher odds of visual field progression (OR: 1.06; 95% CI: 0.90-1.26; = 0.456). The area under the ROC curve to detect progression based on GIP change was 0.49 (95% CI: 0.39-0.60).ConclusionReductions in Hb concentration estimates from fundus photos were not significantly different between progressing and non-progressing eyes. GIP changes overtime were not associated with visual field progression. We believe that the ability to detect glaucoma progression with this method requires improvement.